Wound closure



J- H- GARDNER ET AL WOUND CLOSURE 2 Sheets-Sheet 1 Filed Nov. 8, 1967 INVENTORSI c/4 A flgkio/va? 720/14: ISM/v01 #uRsrJ/R July 14, 1970 GARDNER ET AL 3,520,306

WOUND CLOSURE Filed Nov. 8, 1967 2 Sheets-Sheet y Tlcik. T13 .7.

United States Patent O 3,520,306 WOUND CLOSURE Jack H. Gardner, Highland Park, and Thomas Swindlehurst, Jr., Metuchen, N.J., assignors to Johnson & Johnson, a corporation of New Jersey Filed Nov. 8, 1967, Ser. No. 681,464 Int. Cl. A61l15/01; A61b 17/04 US. Cl. 128-335 11 Claims ABSTRACT OF THE DISCLOSURE The present invention is directed to an improvement in Wound closures of the adhesive type used to span an incision to hold the incision closed during healing without the necessity of stitching. The wound closure comprises a plurality of adhesive strips hingedly connected to each other by means of a film area adapted to cover the entire length of the incision and form an occlusive covering during healing. An absorbent pad is placed over the occlusive covering and extends beyond edges thereof to remove wound exudate.

BRIEF SUMMARY OF THE INVENTION It has heretofore been proposed to use as sutures, to hold the edges of an incision together during healing, pressure sensitive adhesive coated flexible strips which span the incision pulling together the edges and keeping the incision closed during healing without the necessity of stitching. Such an adhesive-type suture is illustrated, for example, in Pat. No. 2,798,492. It has heretofore been the practice to use several such adhesive-type sutures, where the incision was of any appreciable length. The Wound was then covered with a conventional type dressing for protecting the same during the healing process. In accordance with the present invention adhesivetype sutures are devised which act both as a suture to hold the incision closed during the healing process without the necessity of stitching and also act as a dressing giving an ideal environment for wound healing while protecting the same.

In accordance with the present invention a plurality of adhesive-type suture strips are provided, hingedly connected near their center by means of a continuous film section. This film section acts as the wound-contacting surface of the combination suture dressing and provides an occlusive dressing over the incision after the suture dressing has been applied.

Recent work has shown that there is a tendency for Wounds to heal more rapidly if the dressing used is occlusive in nature, i.e., if it either prevents or substantially inhibits the escape of moisture from the immediate wound area. (Nature, Dec. 26, 1963. BiologyEffect of Air Exposure and Occlusion on Experimental Human Skin Wounds, pp. 377-379.) The film area connecting the adhesive suture strips acts as an occlusive covering for the incision thus giving an ideal environment to pro mote healing while at the same time it holds the adhesive strips in hinged relation to each other so that the angle of pull of one with respect to the other can be varied slightly to give the best angle of pull across the incision for closing the same. This is particularly important where the incision does not necessarily follow a straight line. The suture dressing may also provide for an absorbent which extends beyond the edges of the occlusive wound-contacting portion of the dressing to remove wound exudate from the edges of the dressing and thus promote movement of exudate out from under the wound-contacting occlusive film portion of the dressing. This helps to prevent wound exudate from building up under the wound-contacting occlusive film portion with the resulting formation of pockets of wound exudate as such pockets provide an excellent environment for bacteria proliferation and should, accordingly, be avoided where possible.

DETAILED DESCRIPTION OF THE INVENTION The invention is more clearly described by reference to the drawings which show certain embodiments of the same. The embodiments illustrated in the drawings, however, are for the purpose of illustration only, and the present invention is not limited solely to these specific embodiments given. Reference is now made to the drawings which illustrate one embodiment of the present invention.

Referring to the drawings:

FIG. 1 is a top plan view of a dressing of the present invention;

FIG. 2 is a perspective view taken along line 2-2 of FIG. 1;

FIG. 3 is a top plan view of the dressing of FIGS. 1 and 2 prior to removal of the protective facings;

FIG. 4 is a bottom plan view of the dressing-protective facing assembly of FIG. 3;

FIG. 5 is a top plan view of an absorbent pad to be used with the dressings of FIGS. 3 and 4;

FIG. 6 illustrates the application of the dressing of FIGS. 1 and 2 prior to removal of the backing protecting facing strips;

FIG. 7 illustrates the applied dressing of FIG. 6 after removal of the protective facings prior to positioning of the absorbent pad; and

FIG. 8 is a top plan view of the assembled applied dressing of FIG. 7 after the absorbent pad has been secured thereto.

Referring to FIG. 1, the dressing contains a film portion 12 having a central longitudinal axis 13. The film portion 12, which is adapted to cover the wound area to be closed has extending from opposite sides thereof flexible adhesive coated tabs 17, 18, 19, and 20 arranged in pairs. Of these tabs 17 and 20 form one pair and tabs 18 and 19 form another. The tabs in a pair such for example as tabs 17 and 20, extend from opposite sides of the wound-contacting portion 12 and are so positioned with respect to each other that a common axis extending through the same would lie in a straight line intersecting the major axis 13 of the wound-contacting portion at an angle of substantially The tabs 17 and 20 together with the interconnecting film portion or wound-contact ing portion 12 form in essence an adhesive suture strip 10. In like manner the pair of flexible adhesive tabs 18 and 19 cooperate to form what in essence is an adhesive suture strip 11. Thus it can be considered that the dressing illustrated comprises in essence two adhesive-suture strips 10 and 11, hingedly connected together by a continuous film portion 12 which is referred to as the woundcontacting portion and which has a center axis 13. In use the central axis 13 would coincide with the general area of the wound, that is the incision, which is to be closed. Using axis 13 as the point of reference, film 12 can be seen to have its narrowest width at a point midway between the two adhesive strips 10 and 11 and to have its point of maximum Width where it intersects the longitudinal axis of each of these adhesive strips. This provides a hinge portion at 14 which is the point of narrowest width of film 12 which occurs between the adhesive strips 10 and 11. This narrowing down, which results in the hinge portion 14, permtis the axis of suture strips 11 and 10 to be moved relative to each other while still maintaining the film portion 12 substantially fiat along its central axis 13.

Although in the particular embodiment illustrated in the drawings, the suture strips 10 and 11 and the woundcontacting film portion 12 are made from one continuous sheet of flexible film material, if desired, the wound-contacting film portion 12 could be made separate and the suture strips 10 and 11 then secured thereto giving an overall structure similar to that illustrated where the same is formed of a single piece of film.

The suture strips 10 and 11 contain a pressure-sensitive adhesive coating 16 on one side of the same along tab portions 17, 18, 19, and 20 for securing the suture dressing to the skin of a patient, the adhesive 16 being on the same side as that of the wound-contacting surface 21 of the film dressing portion 12.

The suture dressing, as illustrated in FIGS. 1 and 2, is also provided with an absorbent pad 22 which is adhesively-secured to the back of the dressing film 12 by means of a pressure-sensitive adhesive coating 23 as best illustrated in FIG. 2. The pressure-sensitive adhesive coating 23 is applied to the back of the dressing film 12 for the purpose of holding the absorbent pad 22 in place.

Although the particular suture dressing illustrated in the drawings contains but two suture strips 10 and 11, it is readily apparent that the same principles involved and described may be utilized in preparing suture dressings designed for covering longer incisions, the same utilizing three, four, or even more suture strip sections.

The dressing film section 12 is preferably of a transparent or translucent material so that one can see the incision through the same to be sure that the incision is fully closed on application of the suture dressing. Thus, in the preferred assemblage of the dressing the backing absorbent pad is not applied to the dressing until the wound has been closed. Accordingly, in the preferred embodiment of the dressing the composite suture and film portion is packaged without the absorbent pad 22 aflixed. The pad 22 may be packaged in a separate sterile envelope 24 or other container from whence it is removed for placing on the fihn portion 12 after the same has been placed over a wound and the wound edges drawn together.

In FIGS. 3, 4, and 5, the suture dressing is illustrated prior to application with the protective facings or coverings still in place. Referring to FIG. 3, which is a top plan view of the suture dressing with protective coverings and absent the absorbent pad 22 it will be seen that removable protective facings 25 and 26 extend over the adhesive coatings 16 of the suture strips 10 and 11, the protective facing strips 25 and 26 extending over the film portion 12 and terminating in tabs 27 and 28. Protective facings 29 and 30 are applied over the adhesive 23 which is contained on the back of the film portion 12, this adhesive coating being best illustrated as previously indicated in FIG. 2. FIG. 4 is a bottom plan view of the dressing with protective facings but showing the reverse side of that illustrated in FIG. 3. FIG. is a top plan view of the absorbent pad 22 in its protective wrapping 24 the wrapping being partially torn away to disclose the absorbent pad.

FIGS. 6 through 8 show the application of the suture dressing of the present invention to an incision. Referring to FIG. 6, the adhesive suture and wound covering fihn portion of the dressing have been applied to an incision 31 made in the arm 32 of a patient. The protective facings 25 and 26 have been removed and the adhesive suture portions and 11 applied to close the wound. Where the protective facings 29 and 30 are also made of a transparent material as in the preferred embodiment, the surgeon applying the suture dressing can readily determine, by inspection during application, whether the edges of the Wound 31 have been pulled sufliciently close to each other and the wound is properly closed. Because of the hinged relationship resulting from the narrowed width at 14 of the film wound cover portion 12, the suture strips 10 and 11 can be adjusted slightly with respect one to the other in order to obtain the preferred direction of pull in closing the wound. As protective facings 29 and 30 may interfere with such relative movement where a straight line pull is not used the same can be removed prior to application of adhesive suture portions 10 and 11. However, the protective coverings 29 and 30 may be made in separate sections. Dotted line 33, which is purely illustrative, indicate where one such separate covering section would terminate and the other begin. With such a construction relative movement between adhesive suture portions 10 and 11 can be obtained with the protective coverings 29 and 30 still in place. After the suture strips 10 and 11 are in place and the wound 30 has been properly closed, the surgeon then removes protective facings 29 and 30, if not already removed, to uncover the pressure-sensitive adhesive coating 23 on the back of the film dressing portion 12.

The absorbent pad 22 is then removed from its container 24 and secured to the adhesive coating 23.

If little or no wound exudate is to be expected, the protective facings 27 and 28 may be left in place and the absorbent pad 22 dispensed with. However, Where the absorbent pad 22 is used and there is appreciable wound exudate, the exucate will move to the edge of the dressing film portion 12 where it is rapidly picked up and removed by the absorbent pad 20. This rapid removal of the wound exudate prevents the buildup of Wound exudate under the dressing film 12 with resulting separation of the dressing film from the wound surface area. The construction described keeps the dressing area in a moist occlusive condition due to the occlusive nature of the dressing film portion 12 while at the same time removing excess wound exudate.

Certain specific embodiments have been utilized and illustrated in describing the present invention. The invention, however, is not limited to these specific embodiments and may be practiced in other forms which would be apparent to one skilled in the art after reading the present disclosure. The invention is thus not to be limited except as indicated by the appended claims.

Having thus described our invention, we claim:

1. An adhesive wound closure comprising a plurality of substantially parallel flexible adhesive suture strips, spaced from each other, a flexible continuous film intersecting said suture strips and securing them in said spaced relationship with respect to each other, said flexible continuous film narrowing in width between said spaced adhesive suture strips to permit slight relative angular movement between the same said flexible continuous film having one surface thereof adapted to contact and cover a wound when closed by said flexible adhesive suture strips and the other surface of said flexible continuous film containing a pressure-sensitive adhesive coating.

2. An adhesive wound closure comprising a plurality of substantially parallel flexible adhesive suture strips, spaced from each other, a flexible continuous film intersecting said suture strips and securing them in said spaced relationship with respect to each other, said flexible continuous film narrowing in width between said spaced adhesive suture strips to permit slight relative angular movement between the same said flexible continuous film having one surface thereof adapted to contact and cover a wound when closed by said flexible adhesive suture strips and an absorbent pad secured to the surface of said flexible continuous film opposite to that adapted to contact a wound said absorbent pad extending beyond the edge of said flexible continuous fil-m.

3. An adhesive dressing of claim 2 in which said absorbent pad is secured to said flexible continuous film by pressure-sensitive adhesive.

4. An adhesive dressing of claim 1 in which the adhesive of said adhesive suture strips and the adhesive coating on said flexible continuous film are covered with removable protective facings.

5. A dressing for closing wounds comprising a Woundcontacting portion having a major axis extending longitudinally of said wound-contacting portion, pairs of flexible tabs secured to and extending from said wound-contacting portion, a pressure-sensitive adhesive coating on one surface of said tabs said adhesive-coated tabs forming a pair of being disposed with respect to each other on opposite sides of said wound-contacting portion and in substantially straight line relation to each other with the axis of said pair intersecting the major axis of said woundcontacting portion at an angle of substantially 90 to form an adhesive suture strip, said wound-contacting portion having a width between adjacent pairs of adhesive tabs which is substantially less than the width of said woundcontacting portion in the area of the axis of said adhesivecoated tab pairs said wound-contacting portion being formed of a continuous flexible film and containing a pressure-sensitive adhesive coating on the side opposite to the adhesive coating on said tabs.

6. A dressing for closing wounds comprising a woundcontacting portion formed of a continuous film and having a major axis extending longitudinally of said woundcontacting portion, pairs of flexible tabs secured to and extending from said wound-contacting portion, a pressuresensitive adhesive coating on one surface of said tabs said adhesive-coated tabs forming a pair being disposed with respect to each other on opposite sides of said wound-contacting portion and in substantially straight line relation to each other with the axis of said pair intersecting the major axis of said wound-contacting portion at an angle of substantially 90 to form an adhesive suture strip, said wound-contacting portion having a width between adjacent pairs of adhesive tabs which is substantially less than the width of said wound-contacting portion in the area of the axis of said adhesive-coated tab pairs and an absorbent pad contained on one side of said dressing said absorbent pad being on the opposite side of said dressing to that of the pressure-sensitive adhesive contained on said tabs and said absorbent pad extending beyond the edge of said continuous flexible film.

7. A dressing of claim 6 in which said absorbent pad is secured to said continuous flexible film by pressuresensitive adhesive.

8. A dressing of claim 5 in which the continuous flexible film and the pressure-sensitive adhesive coating thereon are both translucent.

9. A dressing of claim 5 in which the adhesive of said tabs and the adhesive coating on said continuous flexible film are covered with removable flexible facings.

10. A dressing of claim 9 in which the continuous flexible film and the pressure-sensitive adhesive coating thereon are both translucent.

11. A dressing of claim 10 in which the adhesive of said tabs and the adhesive coating on said continuous flexible film are covered with removable flexible facings the removable facings covering the adhesive coating on said continuous flexible film being translucent.

References Cited UNITED STATES PATENTS 2,387,131 10/1945 Fernandez 128335 2,798,492 7/1957 Barnes et al. 128-335 2,875,758 3/1959 Fuzak et al. 128157 FOREIGN PATENTS 1,203,376 7/1959 France.

DALTON L. TRULUCK, Primary Examiner U.S. Cl. X.R. 128-156 

